Eyelids are often but not always approached at the time of a facelift, as they are also severely affected by the aging process. However the upper and the lower eyelids are different. The main problem with the upper eyelids is the accumulation of excess skin, as it is a structure that opens and closes frequently and hence wears more. Excess tissue then has to removed which results in a scar. I approach the lower eyelids through a “transconjuctival” technique, without a visible scar, to remove the excess fat (which is the main problem) and not excess skin.
An upper and lower blepharoplasty is generally recommended in most people. It also is normally combined with a facelift, since most facial tissues tend to age at the same rate.
I prefer general anesthesia for a blepharoplasty, as I do for most of my cosmetic work. It takes approximately one hour and it is virtually pain free. Recovery is rapid, but I prefer thatmy patients be careful for about 3 weeks with minimal exposure to sun, heat, and humidity.